This applicant for a two-year competing renewal, under the new guidelines of the NIHM Clinical Mental Health Academic Award, will systematically expand her investigative capabilities through a program of interdisciplinary research and advanced training. She intends to continue research involving the elderly, particularly those with probable Alzheimer's Disease and depression. Her research activities will be integrated with her professional nursing background and promote her skills in clinical sleep research, polysomnography, neuropsychologic testing, and psychometrics. Her independent investigative development will be accomplished by the following activities: 1) implementation of a research program; 2) polysomnography training; 3) independent study with experts; 4) research consultation and teaching; and 5) attendance at national scientific research conferences. The research program for the two year renewal will continue the two complementary research studies. The primary study, "Sleep Apnea and Mental Deterioration in Alzheimer's Disease" aims to elucidate the impact of sleep disordered breathing on the cognitive, affective, and behavioral functioning of elderly with Alzheimer's Disease. More specifically, the study will clarify if development of sleep apnea in Alzheimer's Disease is a correlate of more generalized brain dysfunction and if the presence and severity of sleep apnea actually contributes to impaired mentation, behavior and mood in demented elderly. An additional aim is to prospectively examine the association of sleep disordered breathing with pathophysiology, natural history and clinical course of Alzheimer's Disease. The secondary study, "Alzheimer's Assessment: An Adaptation Instrument", will continue development of a nursing assessment instrument designed specifically for use with Alzheimer's patients in acute psychiatric settings. It is based upon the Roy Adaptation Nursing Model utilizing observational and interview data to measure overall impairment as well as subscores related to Roy's psychological, self-concept, role function and interdependence modes of adaptation.